Dombi - winter 2017
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Generally supportive of VBP as a payment model reform<br />
◦ Details matter!<br />
Details here raise concerns<br />
◦ Amount at risk<br />
• 2% is max in other sectors<br />
• At risk levels may prevent improvements as resources depleted<br />
◦ Measures are complex, subject to manipulation, and leave out<br />
patient stabilization<br />
• Do not reflect chronic care population served in home health<br />
◦ Will overlap with bundling, ACOs, and other innovations<br />
◦ Benchmarks based on all patients with OASIS, not just Medicare<br />
FFS